Pubdate: Tue, 20 Jun 2017
Source: Ottawa Sun (CN ON)
Copyright: 2017 Canoe Limited Partnership
Author: Elizabeth Payne
Page: 6


The group that represents obstetricians and gynecologists in Canada is
watching the pending legalization of marijuana with concern, saying
there is growing evidence suggesting its use by pregnant mothers
negatively affects brain development in their fetuses.

"Our worry is that because it is made legal, people may think it is
not a problem," said Dr. George Carson, president of the Society of
Obstetricians and Gynecologists of Canada.

"While it will be legal, the SOGC's position is that we believe there
are adverse effects on brain development from marijuana consumption
until the brain development is finished, which is not until the early
20s. It is legal, but should be strongly discouraged."

Of further concern is that marijuana is widely promoted among some as
an anti-nauseant during early pregnancy.

"There are safe and more effective medications for nausea in
pregnancy" said Carson. "My hope is that it is not used because of the
adverse effects on brain development."

Although more research needs to be done, a growing body of evidence
points to negative effects on brain development as a result of
marijuana exposure which can potentially affect the executive
functions of the brain and behaviour.

The Society of Obstetricians and Gynecologists of Canada is issuing
new guidelines on substance use during pregnancy later this year,
partly because of the upcoming legalization of marijuana and new
research into its effects, and partly because increased use of opioids.

It is also planning to conduct research to get a better sense of
substance use during pregnancy, as well as during other times in
women's reproductive lifespan.

Substance use is the second leading killer of women during pregnancy,
in part, because of fentanyl, said Jocelynn Cook, chief scientific
officer at SOGC. A recent review of research, by Cook and others,
noted the increased use of opioids among pregnant women is an emerging
trend. "This rise is purported to be a combination of the frequency of
prescribed opioids for pain control in pregnant women, illicit use,
and an increase in opioid substitution programs for treatment of
addiction opioids are now being used by a more diverse population that
includes pregnant women."

"We really want to look at what women are doing now related to
substance use - what is happening during pregnancy, what do women
believe, what are their behaviours and where do they get their

She said the research is important now because the landscape is
changing when it comes to substance use.

"We know that 15 per cent of women drink alcohol during pregnancy, we
don't have the same information around cannabis use we are scrambling
to try to figure out how we can help target those populations."

Canada has some of the highest rates of cannabis use by adolescents
among developed nations. In addition, opioid use is rising rapidly.
There are increasing numbers of babies born in Canada who are addicted
to opioids because their mothers took them during pregnancy.

Carson, who works in Regina, said opioid use during pregnancy is of
growing concern, but can also be an opportunity to improve the health
of substance-using women in some cases. Women who are drug addicts
tend not to be engaged with health care, he said, but will often seek
medical treatment when they are pregnant.

He said getting a pregnant mother who is addicted to opioids into a
methadone program can improve her health and her baby's health.

Although there is a general increase in drug use among pregnant women,
cannabis remains the most commonly used illicit substance. Estimates
of women who use cannabis while pregnant have ranged from just under
two per cent to more than 16 per cent, according to the research by
Cook and others. It's widespread use, the report said,"may be due in
part to its reputation as a harmless drug."
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